Anesthetic management of two patients with insulinoma using propofol--in association with rapid radioimmunoassay for insulin

We experienced anesthetic management of two patients with insulinoma in whom frequent hypoglycemic episodes with blood glucose levels of 39-42 mg.dl-1 had been observed. Each patient received epidural analgesia with a catheter inserted at the T 9/10 intervertebral space. Anesthesia was induced with...

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Bibliographic Details
Published inMasui. The Japanese journal of anesthesiology Vol. 50; no. 2; p. 144
Main Authors Kunisawa, T, Takahata, O, Yamamoto, Y, Sengoku, K, Iwasaki, H
Format Journal Article
LanguageJapanese
Published Japan 01.02.2001
Subjects
Aged
Anesthesia, Epidural
Anesthesia, General
Female
Glucose - administration & dosage
Humans
Insulin - blood
Insulinoma - diagnosis
Insulinoma - surgery
Intraoperative Care
Male
Middle Aged
Monitoring, Intraoperative
Pancreatic Neoplasms - diagnosis
Pancreatic Neoplasms - surgery
Propofol
Radioimmunoassay
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Summary:We experienced anesthetic management of two patients with insulinoma in whom frequent hypoglycemic episodes with blood glucose levels of 39-42 mg.dl-1 had been observed. Each patient received epidural analgesia with a catheter inserted at the T 9/10 intervertebral space. Anesthesia was induced with propofol 80-100 mg and fentanyl 200 micrograms. Tracheal intubation was facilitated with vecuronium 6 mg. Anesthesia was maintained with continuous infusion of propofol and epidural anesthesia. Rapid measurements of immunoreactive insulin (IRI) were useful for localization of insulinoma during surgery. Perioperative plasma glucose levels could be maintained within normal ranges by continuous infusion of glucose. Rebound hyperglycemic episodes were not observed, and IRI was reduced after removal of the insulinoma. General anesthesia using propofol and epidural block is a useful choice for the anesthetic management of patients undergoing an operation for removal of an insulinoma.
ISSN:0021-4892